Biomarkers Predict Mortality in Acute Lung Injury
Author Information
Author(s): Dana McClintock, Hanjing Zhuo, Nancy Wickersham, Michael A Matthay, Lorraine B Ware
Primary Institution: University of California, San Francisco
Hypothesis
Despite effective institution of a lung-protective ventilatory strategy, derangement in the plasma levels of biomarkers reflecting inflammation and disordered coagulation and fibrinolysis would be associated with increased mortality in a cohort of prospectively collected patients with ALI/ARDS.
Conclusion
Abnormalities in plasma levels of markers of inflammation, coagulation and fibrinolysis predict mortality in ALI patients, indicating more severe activation of these biologic pathways in nonsurvivors.
Supporting Evidence
- Higher levels of IL-8 and ICAM-1 were independently predictive of worse outcomes.
- Lower levels of protein C were associated with an increased risk of death.
- All markers except IL-6 were significantly different between survivors and nonsurvivors.
Takeaway
Doctors looked at blood tests from patients with lung problems to see if certain markers could tell if they would survive. They found that some markers were linked to higher chances of dying.
Methodology
Plasma samples and ventilator data were collected from 50 patients with early ALI, and biomarkers were measured using ELISA.
Potential Biases
The study may have been underpowered to show significant associations due to the small sample size.
Limitations
The study had a relatively small cohort of patients and data were not collected on the ventilatory strategy employed prior to enrollment.
Participant Demographics
{"age":"55 ± 16","gender":"56% male","race":{"Asian":"14%","African American":"16%","Hispanic":"16%","Caucasian":"54%"},"conditions":{"sepsis":"36%","pneumonia":"34%","aspiration":"16%","transfusion":"4%","other":"10%"}}
Statistical Information
P-Value
0.04
Confidence Interval
1.1 to 4.0
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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